Cefepime Hydrochloride

(sef’ ah peem)

PREGNANCY CATEGORY B

Drug Classes

Antibiotic

Cephalosporin (fourth generation)

Therapeutic Actions

Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.

Indications

• 
  
  UTIs caused by Escherichia coli, Proteus mirabilis, Klebsiella species, including Klebsiella pneumoniae
  
  
• 
  
  Pneumonia caused by Streptococcus pneumoniae, Pseudomonas aeruginosa, K. pneumoniae, Enterobacter
  
  
• 
  
  Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus group or Streptococcus pyogenes
  
  
• 
  
  Empiric therapy for febrile neutropenic patients
  
  
• 
  
  Complicated intra-abdominal infections in combination with metronidazole
  
  
• 
  
  Unlabeled use: catheter-related bloodstream infections

Contraindications and Cautions

• 
  
  Contraindicated with allergy to cephalosporins or penicillins.
  
  
• 
  
  Use cautiously with renal failure, lactation, pregnancy.

Available Forms

Powder for injection—500 mg; 1, 2 g

Dosages

Adults

0.5–2 g IV or IM every 8–12 hr.

• 
  
  Mild to moderate UTI: 0.5–1 g IM or IV every 12 hr for 7–10 days.
  
  
• 
  
  Severe UTI: 2 g IV every 12 hr for 10 days.
  
  
• 
  
  Moderate to severe pneumonia: 1–2 g IV every 12 hr for 10 days.
  
  
• 
  
  Moderate to severe skin infections: 2 g IV every 12 hr for 10 days.
  
  
• 
  
  Empiric therapy for febrile neutropenic patients: 2 g IV every 8 hr for 7 days.
  
  
• 
  
  Complicated intra-abdominal infections: 2 g IV every 12 hr for 7–10 days.

CrCl (mL/min) Recommended Maintenance Schedule More than 60 (Normal recom-mended schedule) 500 mg every 12 hr 1 g every 12 hr 2 g every 12 hr 2 g every 8 hr 30–60 500 mg every 24 hr 1 g every 24 hr 2 g every 24 hr 2 g every 12 hr 11–29 500 mg every 24 hr 500 mg every 24 hr 1 g every 24 hr 2 g every 24 hr Less than 11 250 mg every 24 hr 250 mg every 24 hr 500 mg every 24 hr 1 g every 24 hr CAPD 500 mg every 48 hr 1 g every 48 hr 2 g every 48 hr 2 g every 48 hr Hemodialysis* 1 g on day 1, then 500 mg every 24 hr thereafter 1 g every 24 hr *On hemodialysis days, cefepime should be administered following hemodialysis. Whenever possible, cefepime should be administered at the same time each day.

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